热疗联合多西他赛、顺铂治疗胃癌腹腔淋巴结转移近期疗效观察

目的 评价热疗联用多西他赛、顺铂方案治疗腹腔淋巴结转移的进展期胃癌患者的近期疗效、不良反应及可行性.方法 对15例晚期胃癌腹腔淋巴结转移患者于第1天静脉滴注多西他赛75mg/m2,第2～4天静脉滴注顺铂25mg/(m2·d),第1天多西他赛及第4天顺铂静滴结束后立即行微波区域深部热疗1次,持续50min.每21天为1个周期,治疗2周期后评定疗效.结果 全组完全缓解(CR)1例,部分缓解(PR)6例,稳定(SD)5例,进展(PD)3例,总有效率46.7%.生活质量改善,总有效率为46.7%.最常见的毒副反应为骨髓抑制,Ⅲ～Ⅳ度粒细胞减少占40.0%,其它毒副反应可以耐受.结论 热疗联合多西他赛、顺铂治疗晚期腹腔淋巴结转移的进展期胃癌患者有较好疗效,毒副作用可耐受.     

DCF方案治疗晚期胃癌的临床观察

目的 观察DCF方案治疗晚期胃癌的疗效及毒副反应.方法 选取晚期胃癌患者45例,DCF方案为:多西他赛75mg /m2静脉滴注第1天,顺铂75mg/m2分2-3d静脉滴注,5-氟尿嘧啶(5-Fu) 500mg/m2静脉滴注第1-5天.每21d为1周期,所有患者至少接受4个周期治疗.结果 完全缓解2例、部分缓解16例、稳定13例、进展14例,总有效率40.0%.临床获益31例(68.9%).疾病无进展时间为(4.28±0.31)个月,生存期为(9.03±0.55)个月.主要毒副反应为骨髓抑制、恶心、呕吐、脱发、肝肾功能损害.结论 DCF方案治疗晚期胃癌疗效较好,毒副反应较常见,骨髓毒性较明显但可耐受.     

多西他赛联合顺铂治疗晚期胃癌的临床观察

目的观察多西他赛联合顺铂治疗晚期胃癌的临床疗效及毒副反应。方法收集2011年1月至2012年12月在我院治疗的17例晚期胃癌患者,所有患者均接受多西他赛（75mg／m2,静脉滴注,第1天）＋顺铂（20mg／m2,静脉滴注,第1—4天）化疗,21d为1周期,共2—6个周期。结果总反应率17．6％,有效率58．8％。无药物相关性死亡事件发生,主要3／4级毒副反应为白细胞减少（11．8％）、恶心呕吐（17．6％）及脱发（58．8％）。结论多西他赛联合顺铂治疗晚期胃癌是可行的,其疗效肯定、毒副反应可耐受。     

多西他赛联合顺铂治疗晚期非小细胞肺癌的疗效观察

目的:探讨多西他赛联合顺铂治疗晚期非小细胞肺癌(NSCLC)的临床疗效。方法:评价分析27例经病理学或细胞学确诊的晚期非小细胞肺癌患者予以多西他赛联合顺铂治疗,多西他赛75mg/m2,第1天静脉滴注;顺铂75mg/m2,第1天静脉滴注;28d为1个周期,观察治疗2~3个周期后的临床疗效及毒副作用。结果:27例中,总有效率为40.74%,中位生存时间38周,一年生存率40%;主要毒副反应为骨髓抑制,无治疗相关性死亡。结论:多西他赛联合顺铂是治疗晚期非小细胞肺癌的较好方案之一,毒副反应可以耐受,值得临床推广应用。     

多西他赛顺铂联合氟尿嘧啶治疗进展期胃癌的疗效观察

目的：观察多西他赛与顺铂联合氟尿嘧啶（DCF方案）治疗进展期胃癌的疗效及毒副反应。方法：多西他赛75mg／m^2,静脉滴注d1,顺铂75m吕／m^2分2d静脉滴注dl-d2,氟尿嘧啶2400mg／m^2持续静点48h,每21d为一周期。连续2个周期。结果：30例患者均可评价疗效,总有效率为86．7％（26／30）,其中初治有效率为88％,复治有效率75％,毒副反应主要是骨髓抑制、脱发、胃肠道反应、腹泻等,均可以耐受。结论：多西他赛联合顺铂、氟尿嘧啶治疗进展期胃癌可以获得满意疗效,是一个较好的化疗方案。     

多西他赛联合顺铂治疗蒽环类耐药晚期乳腺癌疗效分析

目的: 观察多西他赛联合顺铂治疗蒽环类耐药晚期乳腺癌疗效及安全性。方法: 多西他赛75mg/m2,静脉滴注,第1天;顺铂25mg/m2,静脉滴注,第1～3天,21天为1周期,2周期后评价疗效。结果: 35例均可评价疗效,完全缓解(CR)5例,部分缓解(PR)19例,稳定(SD)6例,进展(PD)5例,总有效率(CR+PR)68.6%。毒副反应为恶心、呕吐、脱发和骨髓抑制。结论: 多西他赛联合顺铂治疗蒽环类耐药晚期乳腺癌疗效较好,毒副反应可耐受,可作为该类患者的治疗选择。     

周剂量多西紫杉醇联合顺铂及5-Fu治疗晚期胃癌临床观察

目的 观察周剂量多西紫杉醇联合顺铂及与5-氟尿嘧啶(5-Fu)治疗晚期胃癌的疗效和毒副反应.方法 28例晚期胃癌患者,Karnofsky评分≥70分,预计生存期＞3个月,未接受手术且未行任何化疗.多西紫杉醇25mg/m2静脉滴注,顺铂30 mg/m2静脉滴注,5-Fu 600 mg/m2(24 h持续泵入),均为第1、8、15天使用.行2周治疗后判定疗效并随访.结果 28例患者均完成2个周期以上化疗,其中CR1例,PR 11例,SD10例,PD 6例,有效率42.9%.毒副反应主要表现为骨髓抑制、脱发和消化道反应,其他毒副反应较少,且可耐受,无化疗相关死亡.结论 周剂量多西紫杉醇联合顺铂及5-Fu作为晚期胃癌的一线化疗方案,具有疗效相对较高,不良反应相对较小的优点.     

多西他赛联合顺铂5-氟尿嘧啶治疗晚期胃癌的临床研究

目的：探讨多西他赛联合顺铂、5-氟尿嘧啶治疗晚期胃癌的临床疗效。方法42例晚期胃癌患者采用多西他赛75 mg/m2,静脉滴注,d1;顺铂25 mg/（m2·d）,静脉滴注,d2~4,5-氟尿嘧啶750 mg/（m2·d）,静脉滴注,d2~4,统计分析患者的治疗效果。结果42例患者中完全缓解（CR）1例,部分缓解（PR）14例,稳定（SD）18例,进展（PD）9例,总有效率为35.7%。初治、复治患者总有效率分别为42.8%,32.1%,差异无统计学意义（P>0.05）。进展时间中位数为6.2个月,生存时间中位数为9.1个月,1年生存率为19.0%;化疗过程中常见的不良反应有骨髓抑制、脱发、消化道反应,其中Ⅲ度+Ⅳ度粒细胞减少16例,占38.1%。结论多西他赛联合顺铂、5-氟尿嘧啶治疗晚期胃癌疗效较好,不良反应少,耐受程度好。     

DF/DCF方案治疗晚期胃癌的临床观察

目的:观察多西他赛联合5-氟尿嘧啶持续静脉滴注(DF)方案和多西他赛联合顺铂、5-氟尿嘧啶持续静脉滴注(DCF)方案治疗晚期胃癌的临床效果和毒副反应。方法:经病理组织学证实的晚期胃癌56例随机分为两组,DF组29例,采用多西他赛60mg/m2,D1;5-氟尿嘧啶425mg/m2.d,静脉输液泵连续滴注,D1~5,21天为一个周期。DCF组27例,在DF方案基础上,加用顺铂60mg/m2,D1,21天为一个周期。所有患者至少接受2个周期的化疗。结果:DF组总有效率48.3%,其中CR1例,PR13例;DCF组总有效率51.9%,其中CR1例,PR 13例。两组有效率比较差异无统计学意义(P>0.05)。两组主要毒副反应为骨髓抑制、脱发、消化道反应和关节肌肉酸痛等,DCF组消化道反应显著大于DF组(P<0.01)。结论:DF/DCF方案治疗进展期胃癌的疗效相近,但DF方案毒副反应更易被患者接受,是治疗进展期胃癌的较好方案之一。     

DCF方案治疗进展期胃癌的临床观察

目的:观察多西他赛联合顺铂、5-氟尿嘧啶治疗进展期胃癌的近期疗效和反应。方法:回顾性分析进展期胃癌33例,多西他赛75 mg/m2,静脉滴注,d1;顺铂20 mg/m2静脉滴注,d1~d5;5-Fu 500 mg/m224 h持续泵入,d1~d5。21d为一个周期,2个周期后评价疗效。结果:全组33例患者CR 1例,PR 16例,有效率(CR+PR)51.5%(17/33),中位进展时间为4.6个月,中位生存时间为8.1个月。主要不良反应为白细胞下降。结论:DCF方案治疗进展期胃癌疗效较好,且毒副反应可以耐受。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.